Refinding Connections: Approaches to Depression

Wayne Dodge recommends Johann Hari’s Connections Lost: Uncovering the Real Causes of Depresssion.

Wayne Dodge is a doctor who taught Come Alive and other programs at The Haven for many years. Here he recommends Johann Hari’s book Lost Connections, which argues that depression and anxiety are caused by more than chemical imbalances and are rooted in a variety of personal disconnections. At The Haven, we offer effective ways to work with these disconnections and in this way deal with the ravages of depression.


Lost Connections: Uncovering the Real Causes of Depression – And the Unexpected Solutions. Johann Hari (Bloomsbury, 2018)

I highly recommend this book. I think it has the potential to be a ‘game changer’ in the way in which we think about depression and anxiety in our culture. 

Johann Hari is a journalist – and relates in this book that he has been dealing with depression and anxiety since his adolescence – including long term antidepressants. Hari’s thesis in this book is that depression and anxiety are not ‘simple’ chemical issues – but have their roots in personal ‘disconnections.’

Disconnection from

  • Meaningful Work
  • Other People
  • Meaningful Values
  • Childhood Trauma
  • Status and Respect
  • The Natural World
  • A Hopeful or Secure Future

AND from genetic contributions as well as brain changes (both chemical and physical).

His research and analysis in this book strike me as ‘spot on’ and persuasive – so much so that I will quote from his conclusions extensively as they are better than any summary that I could do (p. 256–7).

The real story, I would explain [to my younger self], has been known to scientists for decades. Depression and anxiety have three kinds of causes – biological, psychological, and social. They’re all real, and none of these three can be described by something as crude as the idea of a chemical imbalance. The social and psychological causes have been ignored for a long time, even though it seems the biologic causes don’t even kick in without them […]

You aren’t a machine with broken parts. You’re an animal whose needs are not being met. You need to have a community. You need to have meaningful values, not the junk values you’ve been pumped full of all your life, telling you happiness comes through money and buying objects. You need to have meaningful work. You need the natural world. You need to feel you are respected. You need a secure future. You need connections to all these things. You need to release any shame you might feel for having been mistreated […]

You are not suffering from a chemical imbalance in your brain. You are suffering from a social and spiritual imbalance in how we live. Much more than you’ve been told up to now, it’s not serotonin; it’s society. It’s not your brain; it’s your pain. Your biology can make your distress worse, for sure. But it’s not the cause. It’s not the driver. It’s not the place to look for the main explanation, or the main solution.

Because you have been given the wrong explanation for why your depression and anxiety are happening, you are seeking the wrong solution. Because you are being told depression and anxiety are misfirings of brain chemicals, you will stop looking for answers in your life and your psyche and your environment and how you might change them. You will be coming sealed off in a serotonin story. You will try to get rid of the depressed feelings in your head. But that won’t work unless you get rid of the causes of the depressed feelings in your life.

No, I would say to my younger self – your distress is not a malfunction. It is a signal – a necessary signal.

I know this is going to be hard to hear, I tell him, because I know how deep your suffering cuts. But this pain isn’t your enemy, however much it hurts (and Jesus, I know how much it hurts). It’s your ally – leading you away from a wasted life and pointing the way towards a more fulfilling one.

Then I would tell him – you are at a fork in the road now. You can try to muffle the signal. That will lead you to many wasted years when the pain will persist. Or you can listen to the signal and let it guide you – away from the things that are hurting and draining you, and toward the things that will meet your true needs.

I have been recommending this book to my medical colleagues as well as my patients – and now to you.


Programs like Come Alive can help if you are dealing with depression and anxiety. Find out more.

Wayne Dodge MD, MPH, DipC has been associated with The Haven since 1981. He was the Clinical Director of an 18-practitioner Medical Clinic and administered the AIDS program for a large medical organization for 15 years. He has led Come Alive, Living Alive Phase I, and New Horizons: Phase III. With Gwen Ewan, he co-created Self-Compassion and a series of programs on Haven skills. He is a proud grandfather who is enjoying retirement and spending time in Seattle with his husband and partner of more than 30 years.

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